Introduction

In 1971, Omran described an epidemiological transition that was characterized by a general increase in the age of the population and a decrease in early mortality [1]. Later on, Bobadilla et al. proposed that a link can be made between this transition and the health needs of the population, defined by changes in its age structure and its causes of death [2]. In the epidemiologic transition, Omran defined an accelerated model, observed in some developed countries like Japan, and a delayed model, which (at that time), was

From: Nutrition and Health: Handbook of Nutrition and Pregnancy Edited by: C.J. Lammi-Keefe, S.C. Couch, E.H. Philipson © Humana Press, Totowa, NJ

seen in most developing countries. The main difference between these two models was in the timing and the pace of change [1].

The demographic transition is characterized by an increase in urbanization and industrialization, an expansion of education, and rising incomes. From the health point of view, it translates into an improvement in medical care and public health. As a result of these improvements, in total there is a decrease in mortality due to infectious diseases [3] but a decrease in fertility reflecting urbanization, education and increased incomes resulting in decreased family size. This precipitates an epidemiologic transition in which aging of the population is seen together with the appearance of the nontransmittable chronic diseases.

Concomitant with the last stages of the epidemiological transition, a nutrition transition, has/is occurring characterized by a change in dietary patterns favoring foods richer in fats, an increased consumption of simple carbohydrates, a reduction in the consumption of fruits and vegetables, and a decrease in physical activity. The transition is seen in practically all developing countries, although the extent of its degree varies depending on the state of development of a particular country.

Many theories have been advanced to explain nutrition transition. Although the "westernization" of the diet and life habits is responsible in part, other factors like a diminution of physical activity and a generalized laissez faire regarding personal health are also responsible [4].

Probably the most remarkable feature of the nutrition transition has been a marked increase in the prevalence of obesity, a serious chronic disease whose most important consequence is an increase in mortality due to its association with chronic ailments including cardiovascular disease. As is true for many chronic diseases, obesity is preventable, but its prevalence has increased steadily in the last decades in both developed and developing countries [4]. Many factors are linked to the development of obesity, the most important being a sedentary lifestyle and nutrition.

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